Provider Demographics
NPI:1588669915
Name:HILLMANN-PRENTICE, RENEE MICHELLE (PT)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:MICHELLE
Last Name:HILLMANN-PRENTICE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 LINCOLN DRIVE
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401
Mailing Address - Country:US
Mailing Address - Phone:410-573-1064
Mailing Address - Fax:410-573-1065
Practice Address - Street 1:1911 LINCOLN DRIVE
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:410-573-1064
Practice Address - Fax:410-573-1065
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2019-07-19
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
MD17012225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist